Background: Complex regional pain syndrome (CRPS) is a chronic, severely disabling disorder characterized by sensory, motor, and autonomic dysfunction that is disproportionate to the initial injury. Although stellate ganglion block (SGB) is widely used, evidence regarding the concordance between pain reduction and patient-reported functional restoration across different disease durations remains inconsistent. Objectives: To evaluate pain reduction using the visual analog scale (VAS) and patient-reported satisfaction with upper limb mobility following ultrasound-guided SGB in CRPS Type I, and to explore the correlation between the injury-to-SGB interval and analgesic response. Methods: This retrospective, uncontrolled cohort study evaluated 46 consecutive patients diagnosed with CRPS Type I who underwent an ultrasound-guided SGB at Imam Khomeini Hospital between 2023 and 2025. The study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Pain severity was assessed using the VAS before the procedure and at 1 week and 1 month after the procedure. Secondary outcomes included patient-reported satisfaction with improvements in upper limb range of motion. Results: Among 46 patients (mean age, 60.9 ± 11.8 years; 65.2% female), pain intensity decreased significantly over time after ultrasound-guided SGB. Mean VAS scores decreased from 9.04 ± 1.01 at baseline to 4.80 ± 2.14 at 1 week (mean difference, -4.24; 95% confidence interval [CI], -4.84 to -3.64; P < 0.001) and to 2.20 ± 1.15 at 1 month (mean difference from baseline, -6.84; 95% CI, -7.28 to -6.40; P < 0.001). At 1 month, 71.7% of patients reported improved mobility (partial, 56.5%, n = 26; complete, 15.2%, n = 7), whereas 26.1% (n = 12) reported minimal improvement and 2.2% (n = 1) reported no improvement. No significant correlation was observed between the injury-to-SGB interval and the magnitude of pain reduction at 1 week (ρ = -0.162, P = 0.282) or at 1 month (ρ = -0.218, P = 0.145). Transient hoarseness (13.0%) and dysphagia (8.7%) resolved spontaneously, and no major complications occurred. Conclusions: In patients with CRPS Type I, ultrasound-guided SGB was associated with significant pain reduction and favorable mobility satisfaction, with no observed association between the injury-to-SGB interval and analgesic response. Given the uncontrolled retrospective design, these findings reflect postprocedural improvements rather than definitive causal efficacy.
Introduction: Fluent aphasia following hemorrhagic stroke can severely impair language, literacy, and cognitive functions; however, evidence regarding intensive multicomponent interventions in Persian-speaking populations remains limited. This single-case study aimed to describe pre- to post-intervention changes following a 10-week multicomponent cognitive-linguistic intervention in a 41-year-old Persian-speaking man with fluent aphasia after a left-hemisphere hemorrhagic stroke, with particular attention to language, literacy, memory, speech rate, and lexical diversity. Case Presentation: The patient received 10 weekly 2.5-hour sessions integrating Oral Reading for Language in Aphasia (ORLA), Multiple Oral Re-reading (MOR), Semantic Feature Analysis (SFA), Phonological Components Analysis (PCA), Schuell's stimulation approach, working-memory training, and verbal short-term memory training. Assessments included the spoken subscale of the Persian Diagnostic Aphasia Battery, using the Aphasia Quotient-2 (AQ2); the Persian version of the Montreal Cognitive Assessment (P-MoCA); verbal fluency; digit span; auditory-verbal memory; speech rate; and Type-Token Ratio (TTR). Cognitive reserve was measured using the Cognitive Reserve Index questionnaire (CRIq = 229). Post-intervention, the AQ2 score exceeded the stated clinical cutoff. Reading, writing, repetition, and auditory comprehension reached or approached ceiling levels; verbal and working-memory measures improved; spontaneous speech rate approached the normal range; TTR exceeded the respective cutoffs in both contexts; and previously absent literacy skills reached maximum scores. No decline was observed. The AQ2 change should be interpreted as a change in test classification rather than evidence of complete clinical resolution of aphasia. Conclusions: This case report documents broad improvements from pre- to post-intervention following an intensive, multicomponent, family-supported cognitive-linguistic intervention in post-stroke fluent aphasia, including improvements in literacy and lexical diversity. Given the single-case pre-post design and the absence of a control condition, these findings do not establish a causal treatment effect.
Background: Autism spectrum disorder (ASD) is associated with difficulties in social communication and emotional processing, which may affect recognition memory for emotional stimuli. Objectives: This study investigated recognition memory for emotional words in children and adolescents with ASD, compared with typically developing peers. Methods: Thirty boys aged 9 - 15 years, including 15 with ASD, participated in this study. Final analyses were conducted on 29 participants. Measures included the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), the Social Communication Questionnaire (SCQ), the Social Responsiveness Scale, Second Edition (SRS-2), and a recognition memory task involving emotional and neutral words. Data were analyzed using independent-samples t-tests, repeated-measures analysis of variance, and Pearson correlation coefficients. Results: Recognition accuracy differed across stimulus types (P < 0.001), with pleasant and neutral words recognized more accurately than unpleasant words. A significant group effect was observed (P < 0.001), indicating lower overall recognition accuracy in the ASD group. The stimulus type × group interaction was not significant. No significant group differences were observed for reaction time or error rates. Better recognition memory was associated with fewer social-communication difficulties. Conclusions: Children and adolescents with ASD showed reduced overall recognition accuracy, although the groups did not differ in their response patterns by emotional word type. These findings also provide preliminary evidence linking recognition memory performance to social-communication functioning in ASD.
Background: Anemia is common among patients with acute ischemic stroke (AIS) and is associated with poorer outcomes, including higher mortality and less favorable recovery. CT-based blood attenuation measurements have been investigated as a noninvasive imaging marker of hemoglobin levels. Objectives: This study evaluates the diagnostic performance of photon-counting detector CT (PCD-CT) for anemia detection using both true non-contrast (TNC) and virtual non-contrast (VNC) images in patients with AIS. Methods: This single-center, retrospective study included 45 AIS patients from a previously investigated cohort who underwent both unenhanced head CT and CT angiography of the supra-aortic vessels on the same PCD-CT system, enabling a vessel-matched comparison of TNC and VNC attenuation measurements in intracranial venous structures. Attenuation measurements were obtained from predefined venous structures, including the great cerebral vein (VCM), superior sagittal sinus (SSS), sigmoid sinus, confluence of sinuses, and internal jugular vein. Hemoglobin levels were classified according to WHO criteria, and correlation, regression, and ROC analyses were performed. Thresholds were selected exploratorily using the Youden index. Results: Forty-five AIS patients were included (20 females, 25 males; mean age 72.2 years), of whom 16 (35.6%) were anemic. TNC measurements in the VCM showed the strongest association with hemoglobin levels (r = 0.75, R2 = 0.56, P < 0.001) and the highest intracranial diagnostic performance for anemia detection (AUC = 0.87; threshold ≤ 42 HU; sensitivity 81.3%; specificity 75.9%). VCM-VNC measurements showed a weaker but significant association with hemoglobin levels (r = 0.51, R2 = 0.26, P < 0.001) and lower diagnostic performance (AUC = 0.72; threshold ≤ 36 HU; sensitivity 87.5%; specificity 62.1%). Among intracranial VNC markers, the sigmoid sinus showed the highest diagnostic performance (AUC = 0.84; threshold ≤ 32.5 HU; sensitivity 81.3%; specificity 79.3%). In the pragmatic non-vessel-matched comparison, internal jugular VNC showed AUC values similar to those of VCM-TNC (0.869 vs. 0.865; DeLong P = 0.485). Conclusions: Attenuation measurements from TNC and VNC PCD-CT images were associated with hemoglobin levels in AIS patients. TNC, particularly in the great cerebral vein, remained the most robust marker in vessel-matched intracranial comparisons. Internal jugular VNC may offer a pragmatic, screening-oriented marker in stroke workflows; however, this non-vessel-matched comparison conflates modality and anatomical-location effects. Prospective validation with time-matched laboratory data is required before clinical implementation.
Introduction: Deep cerebral venous thrombosis primarily affects young individuals, women of reproductive age, and patients with a prothrombotic state. Unilateral thalamic lesions resulting from deep cerebral venous thrombosis are relatively unusual. We describe a rare case of unilateral basal ganglion, thalamus, and splenium of the corpus callosum lesions due to thrombus in the deep cerebral venous system. Case Presentation: A 31-year-old Asian woman presented with acute-onset headache, somnolence, and left limb weakness after a miscarriage. Subsequent investigations, including computed tomography, magnetic resonance imaging, and magnetic resonance venography, confirmed deep cerebral venous thrombosis as the underlying cause of her symptoms. Because of progressive deterioration in symptoms and consciousness, she underwent emergent endovascular treatment and anticoagulation therapy, and her symptoms subsequently resolved without complications. At the 1-year follow-up, she remained asymptomatic. Conclusions: Deep cerebral venous thrombosis can induce unilateral thalamic lesions and lesions in adjacent structures, requiring increased caution in diagnosis and invasive investigations. For patients with severe symptoms despite medical treatment, endovascular intervention may serve as a viable alternative therapeutic option.
